The recent government’s announcement that it will not withdraw NHS treatment from patients who choose to pay privately for additional drugs and care has raised confusion in the health insurance industry.

Experts now question how the so-called “top-ups” might be funded in the future and how ready or willing insurance companies are to step in to develop products specific to a “supplementary” market.

The uncertainty was revealed following the publication of a government-ordered review on the issue by Professor Mike Richards, the national cancer director, which effectively overturned the ban prohibiting health service patients to privately supplement an episode of NHS care.

The appendix in Professor Richards’ report, shows that although many insurers have welcomed his ruling, describing the previous ban as both “nonsense” and “offensive”, some have expressed uncertainty about the feasibility of products tailored to covering the cost of cancer drugs not funded by the NHS.

The uncertainty is thought to be based on concerns about how big a potential top-up market might be. A study for Norwich Union Healthcare, found that 57% of people support the use of top-ups, rising to 70% in the case of cancer drugs. However, just 28% said they would consider using insurance products to fund them.

Reports show that there are signs that some patients may not even receive information about suitable drugs unless their consultant is certain they are available on the NHS.